广域数字化视网膜照相与双目间接检眼镜在早产儿视网膜病变教学中应用的比较  

Comparison of wide field digital retinography and binocular indirect ophthalmoscopy in teaching of the retinopathy of prematurity

作　　者：刘丽丽[1] 李莉[1] 晏红改 Liu Lili;Li Li;Yan Honggai(Department of Ophthalmology,Bejing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院眼科国家儿童医学中心,北京100045

出　　处：《眼科》2024年第2期145-149,共5页Ophthalmology in China

摘　　要：目的比较应用广域数字化视网膜照相和双目间接检眼镜在早产儿视网膜病变(ROP)教学中应用的优势和效果。设计前瞻性比较性教学研究。研究对象北京儿童医院眼科2019-2023年在眼底组轮转进修实习医生42人。方法将42人按照随机对照表分为两组。A组21人,首先应用双目间接检眼镜(简称检眼镜法)进行早产儿眼底教学培训1个月,然后再应用广域数字化视网膜照相(简称视网膜照相法)教学培训1个月;B组21人,首先应用视网膜照相法进行早产儿眼底教学1个月,然后再应用检眼镜法进行眼底教学1个月。1个月末时对A组检眼镜教学效果和B组视网膜照相教学效果进行考核,2个月末时对A组视网膜照相教学效果和B组检眼镜教学效果进行考核。考核内容均为疾病诊断和单眼眼底检查时间。同时对所有人进行两种检查方法的问卷调查。主要指标掌握此检查技术时间,单眼检查时间,疾病诊断评分,问卷评分。结果ROP分区评分中检眼镜法为78.80±9.67,视网膜照相法为79.21±8.90(t=0.352,P=0.726)。plus病变评分中检眼镜法为79.53±9.09,视网膜照相法为77.85±7.81(t=0.901,P=0.370)。R0P分期评分中检眼镜法为82.61±7.67,高于视网膜照相法的78.09±6.34(t=6.165P<0.001)。病变钟点范围评分中检眼镜法为80.85±7.17.低于视网膜照相法的83.33±6.11(t=-10.664,P<0.001)。单眼检查时间检眼镜法为(7.47±1.64)分钟,高于视网膜照相法的(3.30+0.56)分钟(t=15.582,P<0.001)。掌握时间检眼镜法为(15.97±2.77)天,高于视网膜照相法的(7.74±1.13)天(t=13.919,P<0.001)。问卷调查显示,掌握难度、视盘颜色判断、图像颜色真实性、图像立体感、周边视网膜病变清晰程度、检查中患儿哭闹程度、利于治疗否等方面,间接检眼镜法评分分别为8.78±0.84、9.07±0.67、9.09±0.69、9.01±0.64、7.33±0.93、7.61±1.73、6.57±1.11,均高于视网膜照相法的6.07±1.06、5.42±0.86、7.40Objective To compare the advantages and effects of wide area digital retinography and binocular indirect ophthalmo-scope in teaching retinopathy of prematurity(ROP).Design Prospective comparative teaching study.Participants 42 interns in the ophthalmology department of Beijing Children's Hospital from 2019 to 2023.Methods 42 subjects were divided into two groups accord-ing to a random comparison table.Group A included 21 subjects.In the first month,binocular indirect ophthalmoscope(BIO)was used for fundus teaching and training of premature infants and then wide field digital retinography(WFDR)was used for teaching and train-ing for the second month.In group B,21 subjects were treated with WFDR for the first month,followed by BIO for the second month.At the end of the first month,the BIO teaching of group A and WFDR teaching of group B were evaluated.At the end of second months,the WFDR teaching of group A and BIO teaching of group B were evaluated.The assessment contents include disease diagnosis and monocular fundus examination time.At the end of the second month,a questionnaire survey was conducted.Main Outcome Measures Mastering time,monocular examination time,disease diagnosis score,ten characteristics of questionnaire survey.Results The ROP zone scores of BIO and WFDR were 78.80±9.67 and 79.21±8.90(t=0.352,P=0.726).Plus lesion score was 79.53±9.09 for BI0 and 77.85±7.81 for WFDR(t=0.901.P=0.370).The stage score of BI0 was 82.61±7.67.higher than that of WFDR 78.09±6.34(t=6.165.P<0.001).The hour range score of BI0 was 80.85±7.17.which was lower than that of WFDR(83.33±6.11)(t=-10.664.P<0.001).The monocular examination time was(7.47±1.64)minutes for BI0.which was higher than that for WFDR(3.30+0.56)minutes(t=15.582.P<0.001).The mastery time of BI0 was(15.97±2.77)days,which was higher than that of WFDR(7.74±1.13)days(t=13.919,P<0.001).Questionnaire survey show that the scores of difficulty of mastering,color judgment of optic disc,authenticity of image color.three-dimensional image clarity of peripher

关 键 词：早产儿视网膜病变 教学 

分 类 号：R722.6[医药卫生—儿科]